USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1853-1885 > Part 14
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A
RETURN OF A DEATH.
To the Clerk of the Town in which the Death occurred.
1. Date of Death,
2. Name,
.
(Maiden Name),
.
nily, 28,"1885 Charles Lehrenfelds-
3. Sex, and whether single. Married, or Widowed,
Male
1. Color. t .
5. Age,
2
Years,
Months, ..
.Days.
diarrhoea
Disease or Cause of Death,
6 .. Duration of Sickness, By whom certified,
7. Residence, . .
8. Place of Death,
9. Occupation.
10. Place of Birth,
11. Name of Father.
12. Name of Mother,
Laphía 2.
.
1.4.V ..
13. Birthplace of Father,
14. Birthplace of Mother,
15. Place of Interment, .
Signature of Undertaker or other person making the Return, .
Lutze
T
DATED at
1
on
21
1855
* If a Married Woman or Widow.
t If other than White. (M.) Mulatto. (I.) Indian. If of other Races, specify what.
¡ Be very particular to fill all Blanks.]
1
1232 Premuch Er
S'S' those
221 ans
[Public Statutes, Chap. 32, Sect. 5.]
No human body shall be buried or removed from any city or town until a proper certificate has been given by the elerk or registrar to the undertaker, sexton, or other person performing the burial or removing the body. Such certificate shall state that the facts required by this chapter have been returned and recorded; and no clerk or registrar shall give such certificate or burial permit until the certificate of the cause of death has been obtained from the physician, if any, in attendance at the last sickness of the deceased, and placed in the hands of said clerk or registrar; and in cities and towns where there are boards of health, the certificate of the cause of death shall also be approved by such board before a permit to bury is given by the registrar or clerk. Upon application, the chairman of the board of health, or any physician employed by any city or town for such purpose, shall sign the certificate of the cause of death to the best of his knowledge and belief, if there has been no physician in attendance. He shall also sign such certificate, upon applica- tion, in ease of death by dangcrous contagious disease, or in any other event when the certificate of the attending physician cannot for good and sufficient reasons be early enough obtained. In case of death by violence, the medical examiner attending shall furnish the requisite medical certificate. Any person violating the provisions of this section shall be punished by fine not exceeding twenty-five dollars.
PHYSICIAN'S CERTIFICATE.
Vame of Deceased,* -
Charles Schonfeldt. Frischrok. Mas
Wars, July 28. 1880
Date and Place of Death, - died at Diaschova, Duration of Sickness
Disease or Cause of Death, - of
I certify that the abook is the, to the best of my knowledge and belief. 1 . otter to Persue S. Karlhuy other 40 Jessie
ame and Residence of Certifying Pigskin,
Date of Certificate, July 31
188 J. Ja ques
*Or Sex of Infant (not named).
[Extraits from Chapter 32 of the Public Statutes. ]
" SECT. 3. A physician who has attended a person during his last illness shall, when requested within fifteen days after the decease of such person, forthwith furnish for registration a certificate of the duration of the last sickness, the disease of which the person died, and the date of his decease, as nearly as he can state the same. If a physician refuses or neglects to make such certificate, he shall forfeit ten dollars to the use of the town in which he resides."
" SECT. 5. No human body shall be buried or removed from any city or town until a proper certificate has been given by the clerk or registrar to the undertaker, sexton, or other person performing the burial or removing the body. Such certificate shall state that the facts required by this chapter have been returned and recorded; and no clerk or registrar shall give such certificate or burial permit until the certificate of the cause of death has been obtained from the physician, if any, in attendance at the last sickness of the deceased, and placed in the hands of said clerk or registrar; and in cities and towns where there are boards of health, the certificate of the cause of death shall also be approved by such board before a permit to bury is given by the registrar or clerk. Upon application, the chairman of the board of health, or any physician employed by any city or town for such purpose, shall sign the certificate of the cause of death to the best of his knowledge and belief, if there has been no physician in attendance. He shall also sign such certificate, upon applica- tion, in case of death by dangerous contagious disease, or in any other event when the certificate of the attending physician cannot for good and sufficient reasons be early enough obtained. In case of death by violence, the medical examiner attending shall furnish the requisite medical certificate. Any person violating the provisions of this section shall be punished by fine not exceeding twenty-five dollars."
RETURN OF A DEATH. To the Clerk of the Town in which the Death occurred.
1. Date of Death,
2. Name,
July 20/1885- Jahres Ryan-
(Maiden Name),*
3. Sex, and whether single, Married, or Widowed,
4. Color, t .
Inale white-
5. Age, 0 Years. 9 Months, Days. Diarshow
'Disease or Cause of Death,
6.
Duration of Sickness,
By whom certified,
7. Residence, .
8. Place of Death,
9. Occupation,
10. Place of Birth,
Froston.
2
11. Name of Father,
12. Name of Mother,
Mary Ryan Deltanti
13. Birthplace of Father,
14. Birthplace of Mother,
15. Place of Interment, .
Signature of Undertaker #person making the Return,
Summer Ford
DATED at , on
18
* If a Married Woman or Widow. 4.
{ If other than White. (M.) Mulatto. (I.) Indian. If of other Races, specify what.
[Be very particular to fill all Blanks.]
5 wks.
Dr. S. A. Polter. 7
2 ton. Winthrop, Mass
John Ryan
wieland.
malden
[Public Statutes, Chap. 32, Sect. 5.]
No human body shall be buried or removed from any city or town until a proper certificate has been given by the clerk or registrar to the undertaker, sexton, or other person performing the burial or removing the body. Such certificate shall state that the facts required by this chapter have been returned and recorded; and no clerk or registrar shall give such certificate or burial permit until the certificate of the cause of death has been obtained from the physician, if any, in attendance at the last sickness of the deceased, and placed in the hands of said clerk or registrar; and in cities and towns where there are boards of health, the certificate of the cause of death shall also be approved by such board before a permit to bury is given by the registrar or clerk. Upon application, the chairman of the board of health, or any physician employed by any city or town for such purpose, shall sign the certificate of the cause of death to the best of his knowledge and belief, if there has been no physician in attendance. He shall also sign such certificate, upon applica- tion, in case of death by dangerous contagious disease, or in any other event when the certificate of the attending physician cannot for good and sufficient reasons be early enough obtained. In case of death by violence, the medical examiner attending shall furnish the requisite medical certificate. Any person violating the provisions of this section shall be punished by fine not exceeding twenty-five dollars.
PHYSICIAN'S CERTIFICATE.
Jame of Deceased,* -
Date and Place of Death,
disease or Cause of Death, -
James Ryan Anchoof Mass July 20 , 85 .- died at of Wiarchova, Duration of Sickness 5 Notes.
1 me and Residence of Certifying Physicien, safeway . gull belief. ter, to exsin th . Roxbury, mas.
Date of Certificate, Scale, July 31. 1882.
*Or Sex of Infant (not named).
[Extracts from Chapter 32 of the Public Statutes. ]
" SECT. 3. A physician who has attended a person during his last illness shall, when requested within fifteen days after the decease of such person, forthwith furnish for registration a certificate of the duration of the last sickness, the disease of which the person died, and the date of his decease, as nearly as he can state the same. If a physician refuses or neglects to make such certificate, he shall forfeit ten dollars to the use of the town in which he resides."
" SECT. 5. No human body shall be buried or removed from any city or town until a proper certificate has been given by the clerk or registrar to the undertaker, sexton, or other person performing the burial or removing the body. Such certificate shall state that the facts required by this chapter have been returned and recorded; and no clerk or registrar shall give such certificate or burial permit until the certificate of the cause of death has been obtained from the physician, if any, in attendance at the last sickness of the deceased, and placed in the hands of said clerk or registrar; and in cities and towns where there are boards of health, the certificate of the cause of death shall also be approved by such board before a permit to bury is given by the registrar or clerk. Upon application, the chairman of the board of health, or any physician employed by any city or town for such purpose, shall sign the certificate of the cause of death to the best of his knowledge and belief, if there has been no physician in attendance. He shall also sign such certificate, upon applica- tion, in case of death by dangerous contagious disease, or in any other event when the certificate of the attending physician cannot for good and sufficient reasons be early enough obtained. In case of death by violence, the medical examiner attending shall furnish the requisite medical certificate. Any person violating the provisions of this section shall be punished by fine not exceeding twenty-five dollars."
RETURN OF A DEATH.
To the Clerk of the Town in which the Death occurred.
1. Date of Death,
2. Name,
July 31. 1885- Francis &. Minuly.
(Maiden Name),*
3. Sex, and whether single, Married, or Widowed,
4. Color, t .
White.
5. Age,
D .Years,. Months,. Days.
Diarihova
Disease or Cause of Death,
6.
Duration of Sickness,
By whom certified,
7. Residence, .
8. Place of Death,
9. Occupation,
10. Place of Birth,
Boston. win A. M& auley. Rate IN: aully. -
12. Name of Mother,
13. Birthplace of Father,
14. Birthplace of Mother, ·
15. Place of Interment, .
Signature of Undertaker - person making the Return,
Summer Fern
.
DATED at
, on
aug.1.
1883=
* If a Married Woman or Widow.
t If other than White. (M.) Mulatto. (I.) Indian. If of other Races, specify what.
[Be very particular to fill all Blanks.]
Dr. J. a. Potter,
3.3, Ock St. Marston. Winthrop, Mars
11. Name of Father,
Nova Scotia.
St. Johns. New Towneinck. 1.2 2. 4 سالا
termale
[Public Statutes, Chap. 32, Sect. 5.]
No human body shall be buried or removed from any city or town until a proper certificate has been given by the clerk or registrar to the undertaker, sexton, or other person performing the burial or removing the body. Such certificate shall state that the facts required by this chapter have been returned and recorded; and no clerk or registrar shall give such certificate or burial permit until the certificate of the cause of death has been obtained from the physician, if any, in attendance at the last sickness of the deceased, and placed in the hands of said clerk or registrar; and in cities and towns where there are boards of health, the certificate of the cause of death shall also be approved by such board before a permit to bury is given by the registrar or clerk. Upon application, the chairman of the board of health, or any physician employed by any city or town for such purpose, shall sign the certificate of the cause of death to the best of his knowledge and belief, if there has been no physician in attendance. He shall also sign such certificate, upon applica- tion, in case of death by dangerous contagious disease, or in any other event when the certificate of the attending physician cannot for good and sufficient reasons be early enough obtained. In case of death by violence, the medical examiner attending shall furnish the requisite medical certificate. Any person violating the provisions of this section shall be punished by fine not exceeding twenty-five dollars.
PHYSICIAN'S CERTIFICATE.
me of Deceased,*
te and Place of Death, -
case or Cause of Death, - of
died at Diaschova
Francis E. Mª Only Hinthrop Muss- July 31. 1885-
Duration of Sickness 4 votes.
-
I certify that the above is tryff, to the best of my knowledge and belief. e and Residence of Certifying Widely, S. A. otter, Ho Peris It. Roformy, Mas.
Date of Certificate, hunat 1. 1885.
*Or Sex of Infant (not named).
[Extracts from Chapter 32 of the Public Statutes. ]
" SECT. 3. A physician who has attended a person during his last illness shall, when requested within fifteen days after the decease of such person, forthwith furnish for registration a certificate of the duration of the last sickness, the disease of which the person died, and the date of his decease, as nearly as he can state the same. If a physician refuses or neglects to make such certificate, he shall forfeit ten dollars to the use of the town in which he resides."
" SECT. 5. No human body shall be buried or removed from any city or town until a proper certificate has been given by the clerk or registrar to the undertaker, sexton, or other person performing the burial or removing the body. Such certificate shall state that the facts required by this chapter have been returned and recorded; and no clerk or registrar shall give such certificate or burial permit until the certificate of the cause of death has been obtained from the physician, if any, in attendance at the last sickness of the deceased, and placed in the hands of said clerk or registrar; and in cities and towns where there are boards of health, the certificate of the cause of death shall also be approved by such board before a permit to bury is given by the registrar or clerk. Upon application, the chairman of the board of health, or any physician employed by any city or town for such purpose, shall sign the certificate of the cause of dent to the best of his knowledge and belief, if there has been no physician in attendance. "He shall also sign such certificate, upon applica tion, in case of death by dangerous contagious disease, or in any other event when the certificate of the attending physician cannot for good and sufficient reasons be early enough obtained. In case of death by violence, the medical examiner attending shall furnish the requisite medical certificate. Any person violating the provisions of this section shall be punished by fine not exceeding twenty-five dollars
RETURN OF DEATH TO THE CITY REGISTRAR. Fawn Clerk Winther CITY HALL, BOSTON.
Date of Death,
CALU 1 1885
Name,
Sarah. Johnston
Color,t 20
Age
55 years
Months ... days.
Place of Death 3 Ocean Spray 1
Eventtrofe Mas WARD
Street and No.
Residence, Boston Veau Sex. 02. Single Married. Wife of Charles
Occupation,
Birthplace*
Ireland Widow of
Name of Father,
michael
Oymen
Name of Mother,
Susan
Birthplace of Father,*
Birthplace of Mother,*
Cause of ) Primary,.
Duration,
Death Secondary,
Duration,
Place of Interment,
Mille
Date of Interment or removal,
Undertaker or Informant,
Aug 2
Smith
Insert Town and State.
Benjamin. F. Smith, Undertaker. t State whether white or black. No 251 Tremont St, Boston Mass
Ireland
!!
٠٠
٠
3:62 R.C
Rockwell & Churchill, City Printers, 39 Arch Street, Boston.
Winthrop Besten .....
1 1
This Certifies, That Sanaly
Johnston
died on the. 1
day of Cruz 1885, aged 55 years,
months,
days.
CAUSE OF Primary, Dysentery
Duration 3 days
DEATH. Secondary,
Duration
Benjamin. F. Smith, Undertaker. No 261 Tremont St. Tostor Mass
8 1tomgin Physician.
Dungin
~
RETURN OF A DEATH. To the Clerk of the Town in which the Death occurred.
1. Date of Death.
2. Name,
(Maiden Name),*
3. Sex. and whether single, Married, or Widowed,
4. Color, t .
5. Age.
ayu1. 1885. Charles J. Kampen. 0
male. chili 0 Years, ... . 11 Months. . / 3 Days.
Dysentery
Disease or Cause of Death,
6.
Duration of Sickness,
By whom certified,
7. Residence, .
8. Place of Death,
9. Occupation,
10. Place of Birth,
11. Name of Father,
12. Name of Mother, .
13. Birthplace of Father,
14. Birthplace of Mother, .
15. Place of Interment, . ·
Signature of Undertaker or other person making the Return,
DATED at on
18 83.
* If a Married Woman or Widow.
t If other than White. (M.) Mulatto. (I.) Indian. If of other Races, specify what.
[Be very particular to fill all Blanks.]
Potter.
Anthrop. Mass
Cambridge,
Edw. C. Lamprou.
annie Lam
Labie du Fine, Purvinas Cambridge, Man.
Holy! elery- Stalden
[Public Statutes, Chap. 32, Sect. 5.]
No human body shall be buried or removed from any city or town until a proper certificate has been given by the clerk or registrar to the undertaker, sexton, or other person performing the burial or removing the body. Such certificate shall state that the facts required by this chapter have been returned and recorded; and no clerk or registrar shall give such certificate or burial permit until the certificate of the cause of death has been obtained from the physician, if any, in attendance at the last sickness of the deceased, and placed in the hands of said clerk or registrar; and in cities and towns where there are boards of health, the certificate of the cause of death shall also be approved by such board before a permit to bury is given by the registrar or clerk. Upon application, the chairman of the board of health, or any physician employed by any city or town for such purpose, shall sign the certificate of the cause of death to the best of his knowledge and belief, if there has been no physician in attendance. He shall also sign such certificate, upon applica- tion, in case of death by dangerous contagious disease, or in any other event when the certificate of the attending physician cannot for good and sufficient reasons be early enough obtained. In case of death by violence, the medical examiner attending shall furnish the requisite medical certificate. Any person violating the provisions of this section shall be punished by fine not exceeding twenty-five dollars.
PHYSICIAN'S CERTIFICATE.
Jame of Deceased,*
Charles . Lampron, Historik, Mass. Aug. 1. 1885-
Date and Place of Death,
died at
Disease or Cause of Death, - of
Sycentury, Duration of Sickness
4 ways ,
I certify that the above is true, to the best of my knowledge and belief. 3. Glien Potter, 40 Perrin It, Rothen.
amie and Residence of Certifying Physician,
Date of Certificate, Fly 25,
188 6.
*Or Sex of Infant (not named).
[Extracts from Chapter 32 of the Public Statutes. ]
" SECT. 3. A physician who has attended a person during his last illness shall, when requested within fifteen days after the decease of such person, forthwith furnish for registration a certificate of the duration of the last sickness, the discase of which the person died, and the date of his decease, as nearly as he can state the same. If a physician refuses or neglects to make such certificate, he shall forfeit ten dollars to the use of the town in which he resides."
" SECT. 5. No human body shall be buried or removed from any city or town until a proper certificate has been given by the clerk or registrar to the undertaker, sexton, or other person performing the burial or removing the body. Such certificate shall state that the facts required by this chapter have been returned and recorded; and no clerk or registrar shall give such certificate or burial permit until the certificate of the cause of death has been obtained from the physician, if any, in attendance at the last sickness of the deceased, and placed in the hands of said clerk or registrar; and in cities and towns where there are boards of health, the certificate of the cause of death shall also be approved by such board before a permit to bury is given by the registrar or clerk. Upon application, the chairman of the board of health, or any physician employed by any city or town for such purpose, shall sign the certificate of the cause of death to the best of his knowledge and belief, if there has been no physician in attendance. He shall also sign such certificate, upon applica- tion, in case of death by dangerous contagious disease, or in any other event when the certificate of the attending physician cannot for good and sufficient reasons be early enough obtained. In case of death by violence, the medical examiner attending shall furnish the requisite medical certificate. Any person violating the provisions of this section shall be punished by fine not exceeding twenty-five dollars."
RETURN OF A DEATH. To the Clerk of the Town in which the Death occurred.
1. Date of Death,
2. Name,
(Maiden Name),*
Cirquet 4", 85- Cerchie a. Becher
3. Sex, and whether single. Married, or Widowed,
Thate
Abule
4. Color, t
5. Age, .
Years, / Mouthy, 27 Days.
6. Discase or First or Primary
Cause of { Secondary (if any)
Death, By whom certified
7. Residence,
8. Place of Death,
9. Occupation, .
10. Place of Birth, . 7/2020
11. Name of Father, Clarence a Sicher 1
12. Name of Mother, .
13. Birthplace of Father, . Thriller 'rneves
14. Birthplace of Mother, . Ona preis Chvil x14h
15. Place of Interment,
Signature of Undertaker or other person making the Return,
DATED at
Millet,, on.
Una 11
188
* If a Married Woman or Widow.
t If other than white. (A.) African; (M.) Mulatto; (I.) Indian. If of other Races, specify what. [Be very particular to fill all Blanks.]
21 casa
1
nikki
The Undertaker, or other informant, is requested to report the facts-together with the Physician's Certificate of the Causes of Death-to the Town Clerk, BEFORE THIE INTERMENT.
In case of an interment taking place, without the Certificate of Registry of the Clerk of the Town in which the Death occurred (or the deceased resided) having first been obtained, the person having charge of such Interment must FORTHWITH GIVE NOTICE thereof - or report these facts -to said Clerk. Penalty for neglect, twenty dollars.
Blank forms for Returns of Deaths may be obtained from the Town Clerk.
No.
RETURN OF A DEATH. To the Clerk of the Town in which the Death occurred .?
1. Date of Death,
2. Name, (Maiden Name),*
7Aug. 15 0 1xxx Sent to. Joud.
3. Sex, and whether single. Married, or Widowed,
Mbala Jungle
22 fuite
4. Color, t
5. Age, .
27.Years, ...
Months,
Days.
6. Disease or First or Primary
Cause of Secondary (if any)
Death, By whom certified
7. Residence,
8. Place of Death,
H during F. O. Spray @ Architect ...
9. Occupation, .
10. Place of Birth, .
11. Name of Father,
12. Name of Mother, .
13. Birthplace of Father, .
14. Birthplace of Mother, .
15. Place of Interment,
Signature of Undertaker or other person making the Return,
roure
DATED at .. , Aug. 16th
188
* If a Married Woman or Widow.
t If other than white. (A.) African; (M.) Mulatto; (I.) Indian. If of other Races, specify what. [Bo very particuler to fill all Blanks.]
.
Dostaw
George CH
Jebland Man
Talland.
Vector
The Undertaker, or other informant, is requested to report the facts-together with the Physician's Certificate of the Causes of Death -to the Town Clerk, BEFORE THE INTERMENT.
In case of an interment taking place, without the Certificate of Registry of the Clerk of the Town in which the Death occurred (or the deceased resided) having first been obtained, the person having charge of such Interment must FORTHIWITH GIVE NOTICE thereof - or report these facts -to said Clerk. Penalty for neglect, twenty dollars.
Blank forms for Returns of Deaths may be obtained from the Town Clerk.
winthrop August 15th 1885
This Certifies, That
Benj. la. Soud
died on the 15 th day of Aug. 1885, aged 27 years,
months,
days.
CAUSE OF Dysentery
Primary, Duration // days Typhoid Fever Duration 6 days DEATH. S Secondary,
Samuel HtDing in Physician.
.
3
) : :
RETURN OF A DEATH. To the Clerk of the Town in which the Death occurred.
1. Date of Death,
2. Name, (Maiden Name),*
3. Sex, and whether single. Married, or Widowed,
Ihale
4. Color, t
5. Age, .
Years,. Months, .... Days.
6. Disease or { First or Primary
Cause of Secondary (if any)
Death, By whom certified
7. Residence,
8. Place of Death,
9. Occupation, .
10. Place of Birth, .
% M.D Haselloni
11. Name of Father,
12. Name of Mother, . Ella 232 4 10:110
13. Birthplace of Father, .
14. Birthplace of Mother, . 9:02
15. Place of Interment,
Signature of Undertaker another person making the Return,
1
DATED at.
,
on
Chung 18
1887.
* If a Married Woman or Widow.
t If other than white. (A.) African; (M.) Mulatto; (I.) Indian. If of other Races, specify what. [Be very particular to fill all Blanks.]
inthis 1 .- ...
The Undertaker, or other informant, is requested to report the fac's-together with the Physician's Certificate of the Causes of Death-to the Town Clerk, BEFORE THE INTERMENT.
In case of an interment taking place, without the Certificate of Registry of the Clerk of the Town in which the Death occurred (or the deceased resided) having first been obtained, the person having charge of such Interment must FORTHIWITH GIVE NOTICE thereof -or report these facts -to said Clerk. Penalty for neglect, twenty dollars.
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